The topic of this week's RGH E‑Bulletin is Non-Steroidal Anti-inflammatory drugs & cardiovascular risk"Non steroidal anti-inflammatory drugs (NSAIDs) are used for their anti-inflammatory, analgesic and anti-pyretic properties. NSAIDs exert their effect by inhibiting the cyclooxygenase (COX) enzyme. All NSAIDs inhibit the isoenzyme COX-2, however non-selective NSAIDs also inhibit COX-1. Inhibition of COX-1 results in decreased production of prostaglandins and thromboxane, which are involved with gastroprotection and thrombotic effects. Inhibition of COX-2 results in decreased production of prostaglandins and prostacyclins, which are involved with inflammation and decreased platelet aggregation. It is believed that the mechanism for increased cardiovascular adverse outcomes with the use of selective COX-2 inhibitors is due to the lack of inhibition of thromboxane production, in conjunction with inhibition of prostacyclins. The most likely theory for the differences between the NSAIDs in terms of cardiovascular risk is their degree of selectivity for COX-2 compared with COX-1."Click here to read the bulletin in full. The E‑Bulletins are archived on the AusPharmList website here.

Wholesaler Australian Pharmaceutical Industries (API) yesterday reported a loss of $35.1 million for the half year ending Feb 28, 2011. The result was underpinned by a $50 million impairment brought about by revised accounting treatment of financial guarantees as well as timing losses associated with the Queensland floods. Pharmacy sales revenue was down 1.1%, which API says was caused by the recent floods.

MSD announced yesterday that it has launched an educational / promotional campaign, “Osteoporosis: Are you getting all 3?”, designed to raise patient awareness of the need for treatment to include an adequate intake of calcium and vitamin D.

The campaign will encourage patients to discuss their needs for calcium and/or vitamin D, including supplementation sources if required, with their doctor.

This week's poll sought to determine to what extent Twitter is used by pharmacists.

AusPharm's interpretation of the results is that, while Twitter isn't widely used by pharmacists now, it's too early to say that the application is a passing fad, despite the fact that almost 50% of our poll respondents thing 'it is a gimmick and will soon die'.

We'd be very interested to hear whether any 'listers are using Twitter in a clinically or professionally useful way.

Approximately 10% of Pharmacy Alliance members have now left the group as a result of its falling out with wholesaler API. AusPharm understands that these members have struck individual deals with API.

According to Pharmacy Alliance API has now severed ties with the group, declining to participate in its current wholesale tender and withdrawing at short notice from an existing supply arrangement. PAL says that the majority of its members have stood by it and embraced interim supply agreements put in place and that during the last week it has actually added new members.

An API contact told AusPharm that 'API has no further statement or comment to add at this point in time'.

AFL Round 4 had just 7 games and 60 tippers selected all winners correctly. Sally Cairnduff from Victoria Harbour Pharmacy had the best margin so becomes the weekly winner. In 2nd place was Marc Monagle from Frosts Pharmacy with Jeanette Vaughan of Medicare Australia in 3rd position.NRL Round 6

NRL Round 6 was tipper friendly with 34 tippers selecting all 8 winners. It came down to cumulative margin to decide the result and Steve Kerle from Greenslopes Hospital is the weekly winner. In 2nd place was Pam Catterall of Medicross Pharmacy Ipswich with Jim Meehan from Medicare Australia taking 3rd.

AHPRA CEO, Mr Martin Fletcher, said the National Registration and Accreditation Scheme has made it possible for the first time to know how many registered health practitioners there are in Australia at any one point in time, within the 10 professions in the National Scheme.

In the final session of the ACP conference on Saturday in Auckland the IMS Health - College Young Pharmacist Innovation Grant winner Jana Fulcher regaled delegates with an account of her visit to FIP 2010 in Portugal.

Ms Fulcher said that presentations from the other Australian contingent to FIP delegates, including her presentation on Mirixa, had evoked a strong response, with acknowledgement that Australian pharmacy was a global leader in establishing (paid) professional services into mainstream pharmacy practice.

After almost a decade in the job Australian College of Pharmacy President, Trevor Clarkin, announced at last night’s College AGM that he will be standing down from his position as College President.

Mr Clarkin first assumed the role as acting President in 2001 and has held the post ever since, either as Australian Institute of Pharmacy Management (AIPM) president (before AIPM merged with the College in 2004) or as President of the College proper.

Pharmacists have an important role to play in public health : 18/04/2011 :

Pharmacy is well placed to play a major public health role says Queensland drug information pharmacist, educator and researcher, Dr Treasure McGuire. Dr McGuire was speaking during a presentation at the Australian College of Pharmacy conference Forever Young in Auckland on Friday.

The WHO defines public health as 'the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals.'

NSAIDS are highly effective in the treatment of inflammatory pain related conditions but they have widely varying safety and adverse event profiles according to consultant drug information pharmacist Dr Geraldine Moses. Dr Moses was speaking during a presentation at the Australian College of Pharmacy conference Forever Young in Auckland on Friday.

In an entertaining presentation Dr Moses also exploded some NSAID related urban myths, including the most common of all, that NDAIDS must be taken with food.

The 2009 winner of both the QCPP Pharmacy of the Year and the PSA Pharmacist of the Year awards, Nick Logan, gave a presentation to delegates at the Australian College of Pharmacy conference Forever Young in Auckland on Friday that showed that community engagement was one way for pharmacy to remain competitive in an increasingly difficult commerial environment.

The Logan strategy since he bought into his pharmacy in Artarmon, on Sydney's lower, North Shore pharmacy 16 years ago has been to closely engage with the local community, involving himself and his pharmacy in a wide array of community initiatives involving local community groups, businesses and schools.

The TGA is advising health professionals not to administer a second (booster) dose of Pneumovax 23 vaccine pending the outcome of a review of an apparent increased rate of injection site reactions following administration of the second dose.

Preliminary analysis of data received to 14 April for adverse events reported to TGA for Pneumovax 23 vaccine administered since 1 January 2011 show a number of severe reactions including cellulitis, extensive swelling from shoulder to elbow and/or abscess, with a preponderance of second dose (revaccination) reactions.

SIGMA has signed a Memorandum of Understanding (MOU) with healthlinks.net that will see the Guildcare software solution used by SIGMA's 520 strong retail brand network of Amcal, Amcal Max and Guardian Pharmacies.

SIGMA says that its brands are determined to deliver a consumer service that leverages the professional opportunities in the new Community Pharmacy Agreement.

The topic of this week's RGH E‑Bulletin is Pegloticase."There have been relatively few recent advances in pharmacotherapy for the treatment of gout. Current standard therapy includes the use of corticosteroids, colchicine and NSAIDs for acute flares and primarily allopurinol and probenecid as urate-lowering therapy to prevent gout flares. Uricase (urate oxidase) is an enzyme that converts urate (uric acid) to allantoin, a more water soluble metabolite and therefore more easily excreted by the kidneys. Pegloticase (Krystexxa®) is a novel urate-lowering agent approved in October 2010 by the US FDA for use in treatment-failure gout."

Click here to read the bulletin in full. The E‑Bulletins are archived on the AusPharmList website here.